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Evidence summaries

Granulocyte-Colony Stimulating Factors as Adjunctive Therapy for Diabetic Foot Infections

Adjunctive granulocyte-colony stimulating factors (G-CSF) treatment in people with diabetic foot infection appears to reduce the need for surgical interventions, including amputations. It may also improve infection status. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 5 studies with a total of 167 subjects.

G-CSF was associated with a significantly reduced likelihood of lower extremity surgical interventions (RR 0.38, 95 % CI 0.21 to 0.70), including amputation (RR 0.41, 95 % CI 0.18 to 0.95). Moreover, providing G-CSF reduced the duration of hospital stay (MD -1.40 days, 95 % CI, -2.27 to -0.53 days), but did not significantly affect the duration of systemic antibiotic therapy (MD -0.27 day, 95 % CI -1.30 to 0.77 days).

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and blinding).

    References

    • Cruciani M, Lipsky BA, Mengoli C et al. Granulocyte-colony stimulating factors as adjunctive therapy for diabetic foot infections. Cochrane Database Syst Rev 2013;(8):CD006810. [PubMed]

Primary/Secondary Keywords